Platitudes, Panic and Pediatricians

The announcement of the impending departure of a local pediatrician this week would have been troubling enough in a community with a strong young family demographic but when he began to give media interviews indicating his reason for departure as concern over the safety of children due to the current on-call system for pediatricians at our local hospital, it became more alarming than troubling.

 
Physicians rarely give such interviews or make statements such as this publicly; these are serious allegations, and physicians who make them without grounds place themselves in serious risk of professional and even personal sanctions from their professional organization, their colleagues and the government. It is undoubtedly a bold move for any physician to do so, and one has to realize they are either deeply concerned in doing it, or deeply foolish.

 
When the physician in question is one who has garnered tremendous respect, with reportedly 5,000 patients in his care, it would be reasonable to assume he is more likely deeply concerned. And if a physician who is part of the medical system is deeply concerned, then as community members we should be, too.

 
I have been very fortunate in that I and my family have always received excellent general and emergency medical care in our community. Every visit to the Northern Lights Regional Health Centre Emergency Room has resulted in good care, and I have no personal complaints in this regard. However, as someone who has been impacted by the lack of specialty medical care in my community (in my particular case, a local or even visiting ophthalmologist), I am well aware that living in a smaller and remote northern community can be exceedingly difficult when you have a medical concern that requires specialty care. The loss of a pediatrician, regardless of his role as an on-call pediatrician for emergency services, is a concern, as the loss of every medical specialist has the potential to impact quality of life for the residents of this community. His patients, many of whom undoubtedly have specific medical concerns, have every right and reason to be alarmed by his departure, and his concerns over pediatric patients in the ER should not be discounted in any way, and yet Alberta Health Services, in responding to his media interviews, seems to take these concerns rather more lightly than one would hope.

 

This response, posted in an online AHS blog, seems to fall slightly more on the “throwing shade” side of defense than an actual articulate and reasoned presentation of the reassuring facts. Comments made that they were not aware of his departure and the 90-day notice a physician must give in order to move or close their practice seem more intended to distract from the real issue at hand: whether or not pediatric patients are at risk in our local hospital due to the current on-call system that sees practicing pediatricians pulled from their practices, offices and patients when an emergency requiring a pediatric specialist arises.

 
While AHS contends this system has been in place for decades, that alone is hardly reassurance nor a reason to think all is well, as simply because something has worked for a long time does not mean it works well now. In fact, this reasoning may be one of the greatest threats in every human endeavor and not just medicine, as it leads to complacency and an unwillingness to make changes.

 
What was lacking in the AHS response was three things:
1) Data showing that pediatric patients do not wait for excessive time periods to see a pediatric specialist in the ER and that pediatric patients in our community are “well served” as a whole
2) Evidence showing a lack of negative outcomes from the current on-call system (surely they must collect data of this nature, and if not then I have some questions as to how they can contend it is working)
3) Acknowledgement that this situation is deeply alarming for parents and residents of this community, particularly at a time when many individuals are still recovering from a traumatic year and assessing their ongoing quality of life in our community.

 
Platitudes developed as a PR response simple won’t reassure anyone in this situation. The fear, anxiety and almost palpable panic this has created in our community is clear when talking to parents and visiting social media pages they frequent; the departure of one pediatrician (and the rumoured departure of a second) is worrisome enough, but this is not the first physician who has expressed concerns about health care in our region (although most have done far less publicly) or who has left the community. In 16 years, I have been through 5 family physicians, not because I have chosen to change them but as they have left the community citing overly heavy workloads and their own quality of life as factors in their decision. I came here from a very small community in northwestern Ontario with sincere hopes my chronic eye disease would receive better treatment, and have been sadly disappointed to see those hopes dashed as my move from a community of 3,000 people to one of over 80,000 people resulted in no difference in care as I still travel to see a medical specialist and still have no local access to an ophthalmologist, emergency, resident or visiting.

 
And perhaps that is what bothers me most about the AHS response; in their assertion that pediatric patients are “well served”, I wonder if they think other medical concerns in this community are equally well served, like my own, or like mental health concerns for youth, or any of the other myriad issues requiring specialty medical care which are, quite frankly, NOT well served in this community. Does the phrase “well served” become the “home free” of this government agency funded through our tax dollars, and they believe they can walk away without addressing the concerns and anxiety that exists? And by not countering this assertion that we are “well served”, are we allowing them to believe this to be true?

 
Not so fast, AHS. Platitudes will not reassure in this case. Provide some data, discuss some facts and counter the claims this respected pediatrician has made in a manner that befits the alarm he has raised. If the facts support your assertion, provide them, and be prepared for a dialogue with residents of this community as we want to share with you our concerns regarding our own medical experiences, and those of our families. Understand that to some degree this is still a community in crisis, and it is not “situation normal” in our region as we continue to recover from the events of 2016. Tell us about your efforts to recruit new physicians, share with us the data you have developed indicating the system is working and if there are challenges, be honest and transparent about them, as we are already aware they exist. Show us you have a plan to address them, and assure us you will work with our physicians and us to ensure the kind of health care system that helps us to build a robust quality of life in our region.

 
For residents of the region with concerns over health care, pediatric or otherwise, I recommend emailing the Alberta Minister of Health Sarah Hoffman. Share your stories, express your concerns and ensure your voice is heard as the only way to effect change is to be part of making it happen.

 
This story is not over – and it is not even truly the beginning, as I have been here for 16 years and during that entire time health care and access to it has been an issue, particularly any form of specialty medical care. This is an ongoing issue that has flared and subsided over a very long time, and is likely to do so for a long time to come; but we have an opportunity at this point to ask for some answers as in this case some very serious, and very troubling, allegations have been made.

 
It is now up to Alberta Health Services to respond to them – and with something more than a blog post containing platitudes and hollow reassurances.

One thought on “Platitudes, Panic and Pediatricians

  1. Great questions.
    I would not want to work a 40 hour (ha ha) week in my office while concurrently being on call 24 hours a day.

    My daughter is currently seeing a pediatric ophthalmologist who is, of course, in Edmonton.

    Over the years we have travelled for numerous specialists. I guess 4 hours is considered well served…

    We do have some health options we didn’t before. The MRI is a big plus. But I have also gone through numerous doctors in 20 years, always because they leave town, not by choice.

    Like

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